TY - JOUR
T1 - Multicenter experience with performance of ERCP in patients with an indwelling duodenal stent
AU - Khashab, Mouen A.
AU - Valeshabad, Ali Kord
AU - Leung, Wesley
AU - Camilo, Joel
AU - Fukami, Norio
AU - Shieh, Frederick
AU - Diehl, David
AU - Attam, Rajeev
AU - Vleggaar, Frank P.
AU - Saxena, Payal
AU - Freeman, Martin
AU - Kalloo, Anthony
AU - Siersema, Peter D.
AU - Sherman, Stuart
PY - 2014/3
Y1 - 2014/3
N2 - Endoscopic retrograde cholangiopancreatography (ERCP) in patients with a preexisting duodenal stent covering the papilla is particularly challenging. The aim of this study was to describe a multicenter experience of performing ERCP in patients with biliary obstruction in whom the papilla was obscured by a preexisting duodenal stent. A total of 38 patients with preexisting duodenal stents obscuring the papilla underwent ERCP. Endoscopic biliary cannulation was successful in 13 patients (34.2%). In 12 of these 13 patients (92.3%), endoscopic therapy was performed during the same procedure and achieved clinical success with relief of jaundice in all cases (100%). The most commonly utilized procedure in patients in whom ERCP failed was EUS-guided biliary drainage (EGBD; n= 13/22, 59.1%), followed by percutaneous transhepatic biliary drainage (n= 9/22, 40.9%). Three patients in whom ERCP failed either did not consent to further intervention or were transferred to other centers. Thus, ERCP was technically challenging in our cohort of patients with preexisting duodenal stents, but was nonetheless successful in about one third of cases. Overall, when performed by experts, endoscopic biliary drainage (via ERCP or EGBD) can be successfully achieved in the majority of patients with indwelling duodenal stents.
AB - Endoscopic retrograde cholangiopancreatography (ERCP) in patients with a preexisting duodenal stent covering the papilla is particularly challenging. The aim of this study was to describe a multicenter experience of performing ERCP in patients with biliary obstruction in whom the papilla was obscured by a preexisting duodenal stent. A total of 38 patients with preexisting duodenal stents obscuring the papilla underwent ERCP. Endoscopic biliary cannulation was successful in 13 patients (34.2%). In 12 of these 13 patients (92.3%), endoscopic therapy was performed during the same procedure and achieved clinical success with relief of jaundice in all cases (100%). The most commonly utilized procedure in patients in whom ERCP failed was EUS-guided biliary drainage (EGBD; n= 13/22, 59.1%), followed by percutaneous transhepatic biliary drainage (n= 9/22, 40.9%). Three patients in whom ERCP failed either did not consent to further intervention or were transferred to other centers. Thus, ERCP was technically challenging in our cohort of patients with preexisting duodenal stents, but was nonetheless successful in about one third of cases. Overall, when performed by experts, endoscopic biliary drainage (via ERCP or EGBD) can be successfully achieved in the majority of patients with indwelling duodenal stents.
UR - http://www.scopus.com/inward/record.url?scp=84896712434&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84896712434&partnerID=8YFLogxK
U2 - 10.1055/s-0033-1359214
DO - 10.1055/s-0033-1359214
M3 - Article
C2 - 24500975
AN - SCOPUS:84896712434
SN - 0013-726X
VL - 46
SP - 252
EP - 255
JO - Endoscopy
JF - Endoscopy
IS - 3
ER -